Four tips for relieving stress in long-term care

Stress is hurting the job performance of a huge number of people in this country — and long-term care workers are among those at greatest risk. That's the suggestion from poll results released Monday from NPR, the Harvard School of Public Health and the Robert Wood Johnson Foundation. The findings indicate that facilities would be smart to proactively help staff manage their stress.

About half of the 2,500 survey respondents said they have experienced major stress in the past year, according to “The Burden of Stress in America” report. This extrapolates to about 115 million people experiencing severe stress in a given year — and even this is probably a “massive underestimate,” NPR reported.

Looking more closely at the results, long-term care professionals should see red flags. Of those who experienced extreme stress in just the previous month, 36% said it was because they “often experience dangerous situations at work.” Nursing homes are the most dangerous workplaces in the country, judging by government statistics.

Then there's this: 36% of respondents cited “income less than $20,000” as causing high stress levels in the past month. A recent HBO documentary showed just how hard it is for one nursing home CNA to make ends meet on $9.50 an hour.

Hazardous jobs and low wages pale in comparison to the stress-inducing effects of poor health. Of the “high stress in the last month” group, 60% attributed the stress to poor health, 45% to a disability and 36% to a chronic illness. Of the “high stress in the last year” group, 16% linked it to the death of a loved one.

Nursing home workers are in constant contact with people experiencing stress due to these factors. And this likely is rubbing off — another recent study, from St. Louis University, focused on the phenomenon of “second-hand stress.” The upshot: Stress is contagious.

About two-thirds of people in the NPR poll said stress negatively affected their work life in the past month. Specifically, 50% said stress made it harder to concentrate, 40% said it interfered with taking on additional responsibilities, and 37% said it became harder to complete their work in a timely manner. So alleviating stress could really improve staff performance in long-term care settings. Here are four strategies to consider:

Encourage fresh air breaks: Respondents to the NPR poll shared their favored stress relief techniques. “Spending more time outdoors” was the stress-reduction activity that ranked highest, in terms of how many people said it was effective (a whopping 94%). Does your facility have an inviting outdoor space where staff could eat a sandwich or have a cup of coffee? If such a space exists, are workers actively encouraged to use it? Regularly spending time on a hobby, exercising, spending time with a pet and meditating/praying all also ranked highly.

Assign predictable shifts:NPR highlighted how predictable shifts reduce stress, especially for working parents who have to worry about child care and transportation. I know many long-term care facilities are facing turnover and a shortage of applicants. And as the Affordable Care Act kicks in, many are trying to manage employees' work hours to keep health insurance costs in check. So, the trend is toward more nimble scheduling — which could mean more last-minute or variable shift assignments. While the factors behind this trend could make it difficult for providers to assign more predictable shifts, managers should be aware of the burden posed by highly variable schedules. They might want to consider technology that can help make shift assignments as consistent as possible.

Foster teamwork: People under stress produce the hormone oxytocin. Known as the “cuddle chemical,” it prompts people to seek out and strengthen connections with others, noted Stanford University health psychologist Kelly McGonigal, Ph.D., in a popular TED talk about stress. Considering that seeking out support is spurred by a physiological response to stress, workplaces that isolate workers rather than build teamwork could be driving stress levels through the roof — as illustrated by some research carried out in long-term care facilities. The oxytocin response also could help explain why spending time with friends and family is another highly effective stress reliever.

Promote smartphone use: This suggestion is a little tongue-in-cheek, but short breaks to play smartphone games or surf social media really do improve workers' well-being, according to recent research out of Kansas State University. It sounds like the finding may be related to the oxytocin response. Facebook and Twitter — and even some game apps — are a way of interacting with friends and family, study author and doctoral student Sooyeol Kim pointed out.

“These days, people struggle with a lot of different types of stressors,” Kim observed. “Smartphones might help and that is really important not only for individuals, but for an organization, too.”

Makes sense to me. In fact, I think it's time for a status update: “Relieving stress by checking Facebook at the office. #ThanksSooyeol.”

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Daily Editors' Notes

McKnight's Daily Editors' Notes features commentary on the latest in long-term care news and issues. Entries are written by Editorial Director John O'Connor, Editor James M. Berklan and Senior Editor Elizabeth Newman.